Using 18F-FDG positron emission tomography/computed tomography to judge benign or malignant colorectal hypermetabolic lesions.
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BACKGROUND AND OBJECTIVE: The colorectum is long and its position is not fixed. The thickness of the colorectal wall is unfixed because it changes following wall contractions. The metabolism of the colorectum is not stable and abnormal metabolism results from smooth muscle movement, gland action, spasm, inflammation, and so on. These anatomic and physiologic factors can bring a few difficulties in correctly judging colorectal information on 18F-FDG positron emission tomography/computed tomography (PET/CT) scans. This study was to discuss the imaging characteristics of colorectal hypermetabolic lesions in 18F-FDG PET/CT and their value to clinical diagnosis. METHODS: According the metabolic characteristics and the shape of the lesion, 118 colorectal hypermetabolic lesions of 74 patients were detected by 18F-FDG PET/CT and separated to 6 groups (localized/CT+, localized/CT-, segmented/CT+, segmented/CT-, diffuse/CT+, diffuse/CT-). To contrast groups and the qualitative data, a RxC Chi2 test was performed to judge statistical differences. RESULTS: In the 118 lesions, 50 were determined to be malignant and 68 nonmalignant. A total of 30 lesions were in the localized/CT+ group (23 malignant, 7 non), 35 to the localized/CT- group (22 malignant, 13 non), 4 to the segmented/CT+ group (4 malignant, 0 non), 35 to the segmented/CT- group (1 malignant, 34 non), 0 to the diffuse/CT+ group, 14 to the diffuse/CT- group (0 malignant, 14 non). The rates of nonmalignant lesions in the segmented/CT- and diffuse/CT- groups (97.1%, 100%) and of malignant lesions in the segmented/CT+ groups (100%) were similar, so these three groups were combined to a nonlocalized group. The group of diffuse/CT+ was deleted. There were significant differences among the three groups of nonlocalized, localized/CT+, and localized/CT-(P < 0.001). The localized/CT+ and localized/CT- groups were combined into one localized group because no significant difference was found between them (P = 0.229). There was a significant difference between the nonlocalized and the localized groups (P < 0.001). CONCLUSIONS: On 18F-FDG PET/CT, colorectal hypermetabolic lesions in the diffuse/CT- or segmented/CT- groups were highly likely to be nonmalignant and those in the segmented/CT+ group were highly likely to be malignant. Lesions in the localized/CT+ or localized/CT- groups had only a normal likelihood of being malignant. To correctly diagnose colorectal hypermetabolic lesions, it is necessary to analyze the PET of the metabolism and the CT of the anatomy together. Especially for the metabolic lesions of the localized/CT- group, we cannot easily make the judgment of malignant or nonmalignant unless we refer to the relevant clinical data. (+info)
Early monitoring of radiotherapeutic effects of nasopharyngeal carcinoma xenografts in nude mice using 18F-FDG PET-CT imaging.
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BACKGROUND AND OBJECTIVE: Monitoring the therapeutic effects of radiotherapy for nasopharyngeal carcinoma (NPC) is critical to providing individualized treatment. This in-vivo study was initially designed to evaluate the therapeutic effect of radiotherapy using 18F-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET-CT) imaging. METHODS: 18F-FDG PET-CT imaging was performed on all of the 10 nude mice bearing NPC xenografts before radiotherapy, and early-phase and delayed-phase PET-CT images were performed on 7 of the 10 mice. All mice were randomly divided into either a control group or a radiotherapy group. The 5 mice in the control group were immediately killed after the imaging and pathology were performed. After receiving radiotherapy of 12 Gy, 5 animals in the radiotherapy group were given 18F-FDG PET-CT imaging on days 2, 4, and 6, and then were killed for pathologic evaluation. Regions of interest (ROI) technology was used to measure the tumor target/non-target (T/NT) ratio and the volume of the tumors. RESULTS: The average T/NT ratios of early- and delayed-phase imaging were 1.806 +/- 0.532 and 1.777 +/- 0.597, respectively, with no significance (P > 0.05). For the radiotherapy group, the average T/NT ratios for 18F-FDG PET-CT before radiotherapy, and on days 2, 4, and 6 after radiotherapy, were 1.735 +/- 0.466, 1.818 +/- 0.396, 1.096 +/- 0.101, and 0.604 +/- 0.108, respectively, The tumor volumes were (1.48 +/- 0.27) cm3, (1.57 +/- 0.31) cm3, (1.59 +/- 0.31) cm3 and (1.60 +/- 0.29) cm3, respectively. The average T/NT ratios of day 6 after radiotherapy and the other time points were significant (P < 0.05). The average death ratio of the tumor cells was (93.00 +/- 7.42)% after 6 days of post-radiotherapy. CONCLUSIONS: 18F-FDG PET-CT imaging can be used for the early assessment of radiotherapeutic effect of NPC in vivo. Day 6 after radiotherapy may be an appropriate time point for the imaging. However, the T/NT ratio measurement of delayed-phase imaging might make no sense for the diagnosis of NPC. (+info)
Percutaneous radiofrequency ablation approach through the spleen: initial case report for pancreatic tail gastrinoma.
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Gastrinoma has a low incidence, and the pancreas-originated gastrinoma is rare. Pancreatic gastrinoma patients with liver metastases have poor prognosis and short survival. Local treatment to reduce the tumor burden helps to improve symptoms and slows down tumor progression for patients with unresectable tumors. We report a case of pancreatic tail gastrinoma with unresectable liver metastases. The patient received a comprehensive minimally invasive interventional treatment, that is, chemoembolization and radiofrequency ablation for liver metastases, and percutaneous transplenic radiofrequency ablation combined with radioactive 125I seed implantation for pancreatic tail gastrinoma. The patient was followed up for more than 20 months, and showed no clear evidence of tumor recurrence. We explored the safety and feasibility of percutaneous transplenic radiofrequency ablation for unresectable pancreatic tail gastrinoma. This transplenic approach allow more indications for minimally invasive therapy and provides a new treatment option not only for patients with unresectable pancreatic tail tumor but also for patients refusing surgery. (+info)
Considerations of treatment standardization from the procession of NCCN guideline of esophageal cancer.
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Esophageal carcinoma is one of the most common malignant tumors, especially in China which is the high incidence area. As a result of mild symptoms of early-stage esophageal cancer, the majority of patients cannot be diagnosed until they develop to advanced cancer, and the treatment outcome of surgery or chemoradiotherapy is still unsatisfactory at present. The guidelines of esophageal cancer issued by National Comprehensive Cancer Network (NCCN) are regarded as important reference tools by clinical oncologists, and provide uniform criteria for the diagnosis and treatment of esophageal carcinoma. However, the guidelines are not always suitable for Chinese patients because the data come from European and American population which have significant ethnical difference from Chinese. We retrospectively analyzed the changes of treatment strategy of esophageal cancer in NCCN guidelines and the advance of treatment for esophageal carcinoma in China, aiming to provide our oncologists with new research ideas. We also hope to set up clinical cancer cooperation organizations, and release our own cancer guidelines to serve Chinese patients and oncologists. (+info)
Quantitative assessment of diffusion-weighted MR imaging in patients with primary rectal cancer: correlation with FDG-PET/CT.
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Primary malignant bone neoplasm: a case report of dedifferentiated chondrosarcoma in the rib and review of the literature.
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Dedifferentiated chondrosarcoma (DDCS) is a rare but highly malignant primary bone neoplasm, which is resistant to radiotherapy and chemotherapy. There remains uncertainly as to the best treatment of this disease and how to improve its prognosis. In this paper we reported a case of DDCS and reviewed the related literatures in order to provide references to throw a light on the histogenesis, diagnosis and therapy of this disease. (+info)